1. Field of the Invention
The present disclosure relates to a surgical securement apparatus and a surgical securement and marking system. In more particular, the present disclosure relates to a surgical securement apparatus configured to provide desired gripping of a securement cord which is positioned around one or more intracorporeal structures during a surgical procedure. Additionally, the present invention relates to a securement and marking system configured to facilitate securement, isolation, and identification of intracorporeal structures.
2. Relevant Technology
A variety of surgical procedures require a practitioner to gain access to a patient's thoracic cavity, abdominal cavity or another location within the patient. These procedures often require separating, identifying, and grouping various intracorporeal structures, such as nerves, blood vessels (arteries and veins), and tendons. Sorting the intracorporeal structures allows the practitioner to identify the particular structures to be repaired and to guard against accidental operation on, or damage to, such structures not involved with the procedure. During the course of a surgery, the practitioner may isolate one or more target intracorporeal structures to perform particularized procedures on the structures. A practitioner may also identify various intracorporeal structures that are not being repaired and tie them together or otherwise secure them safely on the periphery of the surgical site. In this manner accidental cutting or otherwise damaging such structures can be avoided.
A variety of techniques have been utilized to secure and at times isolate nerves, vessels, and tendons during a surgical procedure. The techniques generally involve providing a securement loop around the structures to be secured. Typically the securement loop is made of a soft woven tape or cord, such as umbilical tape, that will not inadvertently cut, slice or otherwise damage the structures. Moreover, the techniques can include the use of ties and clamps to secure the securement cord around the structures.
One technique which has traditionally been utilized is simply looping a short section of cord around a target structure and securing the cord utilizing a knot. For description purposes the cord and knot can be referred to as a tie. A significant shortcoming of this technique is the possibility of the tie falling into the surgical area. Blood and fluids in the surgical area can cover or otherwise obscure the tie such that the practitioner may fail to remove the tie at the end of the procedure. Leaving a tie inside a patient after a surgery can cause discomfort, hemorrhaging and increase the possibility of infection. Another significant shortcoming of a simple tie arrangement is that the knot of the tie can be difficult to release once the procedure is over. Leaving the ends of the cord long enough to extend outside the surgical site can help prevent accidental loss of the tie. However, the additional length of cord introduces challenges in initially forming the knot, and the additional length of cord does not help resolve the problems associated with releasing the knot. In light of these shortcomings other techniques have been developed to secure intracorporeal structures during a medical procedure.
Another technique used to secure structures from outside the surgical site employs a section of tubing in connection with a securement cord. The securement cord is threaded in a loop around a target structure. After looping the securement cord around the target structure, the ends of the cord are then threaded through the section of tubing. A distal end of the tubing can be positioned near the structure to enable cinching or tightening of the loop around the structure. A hemostat or clamp can then be placed at the proximal end of the tubing to secure the position of tubing along the loop of cord. The proximal end of the tubing and the hemostat or clamp can remain safely outside the surgical site and the distal end of the section of tubing can hold the loop of securement cord taut around the structure.
The use of this type of securement arrangement utilizing tubing and a hemostat or another clamp, can have several shortcomings. The securement cord loop cannot be pre-threaded through the tubing due to the fact that many of the target structures do not have identifiable or accessible endings around which a pre-formed loop could be threaded. Moreover, quickly and efficiently threading the securement cord through the tubing during the surgical procedure is challenging. For example, introducing one or both ends of the securement cord into a tubing with a small diameter can be complicated and cumbersome. Another shortcoming is that the weight of the hemostat or other clamping device can potentially result in excessive strain on the structures.